Experts debate reasons for fall in carpal tunnel cases

Still discussing why reports of RSI are in decline ...

"Can a workplace epidemic be cured?

With the personal computing boom of the 1990s came thousands of “repetitive stress injuries” or “repetitive strain injuries.” RSI became the hip medical acronym of the keyboard era, with subset carpal tunnel syndrome the diagnosis of the day.

“At its height of diagnosis, anybody showing up at a doctor’s office with wrist pain or hand pain was being diagnosed with carpal tunnel,” said Carol Harnett, vice president of insurer Hartford Financial Services Group’s group benefits division.

Since then, carpal tunnel cases have plummeted, declining 21 percent in 2006 alone, according to the Bureau of Labor Statistics. Among workers in professional and business services, the number of carpal tunnel syndrome cases fell by half between 2005 and 2006.

What changed?

First, it may not have been the white-collar epidemic it appeared to be.

A 2001 study by the Mayo Clinic found heavy computer users (up to seven hours a day) had the same rate of carpal tunnel as the general population. Harvard University headlined a 2005 news release: Computer use deleted as carpal tunnel syndrome cause.

“Clearly, if keyboarding activities were a significant risk for carpal tunnel, we should have seen, over the last 10 to 15 years, an explosion of cases,” said Dr. Kurt Hegmann, director, the Rocky Mountain Center for Occupational & Environmental Health. “If keyboarding were a risk, it cannot be a strong factor."

Blue-collar workers, especially those doing assembly line work such as sewing, cleaning and meat or poultry packing, have a far greater incidence of carpal tunnel than white-collar workers, according to Bureau of Labor Statistics data.

RSI label dropped
That doesn't mean white-collar workers don't get carpal tunnel and related disorders. But it may mean such disorders were overdiagnosed when they were most in the news, resulting in an artificially high number of cases by the late 1990s. Most doctors have dropped the term RSI, calling them "musculoskeletal disorders" while government agencies like "cumulative trauma disorders."

Now, some experts think some of those patients had "referred pain" from trouble elsewhere, such as the neck. Other theories claim attention to ergonomics has prevented injuries, or that they have become underreported because they lack the immediacy of a broken bone.

People who've had a cumulative trauma disorder say it can be debilitating. Clay Scott, now an assistant professor of electrical engineering and computer science at the University of Michigan, developed severe wrist pain during college at Harvard University. By the end of his senior year, he said he was incapable of doing daily tasks, such as cutting food and opening doors.

His recovery started with physical therapy a few times a week and a home exercise program to stretch and strengthen his back and neck muscles. It took three or four years for him to recover, he said.

Stopping it before it starts
Some businesses have been focusing on prevention, part of a growing effort by employers to keep their workers healthy.

Outdoor clothing company L.L. Bean shuts down its manufacturing line three times a day for mandatory five-minute stretches. Retailer Replacements Ltd. also runs on-the-clock group stretches as well as a fitness-walking program.

Blue Cross Blue Shield of Kansas started a program in 1991, when costs of the injuries to its employees passed $500,000. It bought ergonomic chairs and desks, introduced ergonomic assessments for new employees during their first two weeks of work and hired two full-time registered nurses to work with employees.

Since the program started, the company's workers' compensation costs have fallen by 62 percent, said Terri Janda, a nurse who leads the Blue Cross program."    (Continued via Houston Chronicle)    [Ergonomics Resources]

Prevention of repetitive stress injuries of the forearm, wrist and hand by use of an ergonomic paint brush

The ergonomic paint brush and research leading to its development ...

... Humans are plagued by numerous conditions, which can as a group can be called repetitive stress injuries or cumulative micro trauma disorders. Included is this category are "MSD's" or musculoskeletal disorders which refer to conditions that involve the nerves, tendons, muscles and supporting structures of the body.

There are several conditions to consider within the hand and wrist region. Combined work factors of forceful and repetitive use of the hands and wrists are associated with carpal tunnel syndrome. Workers in industries which spend their workdays performing forceful exertions and repetitive movements of the hand and wrist have been found to have a strong association with tendonitis of the wrist and have also been found with disorders of the elbow such as epicondylitis. Carpal tunnel syndrome is usually associated with a) ill-designed tools, poor job techniques and repetitive work processes involving the hands.

My initial analysis began with a review of available research on the subject of musculoskeletal disorders, carpal tunnel syndrome and other reviews of epidemiological evidence for work-related disorders of the hand, wrist and forearm. Here we are interested in those conditions specifically related to repetitive flexion/extension and side bending of the wrist as well as forceful and or prolonged gripping of the fingers. We have chosen these particular activities because they are the movements involved the use of the standard paintbrush. Contained in Table 1 below are some of the most frequent disorders associated with these movements.

Further, research supports the fact that "repeated or continuous contact with hard or sharp objects such as non-rounded desk edges or unpadded, narrow tool handles may create pressure over one area of the body (e.g., the forearm or sides of the fingers) that can inhibit nerve function and blood flow".

NIOSH's publication, Elements of Ergonomics Programs succinctly summarizes as follows: "The affect of repetition on intramuscular tissue, nerves and joints is also an important consideration. A series of motions performed every few seconds with little variation may produce fatigue and muscle-tendon strain. If adequate recovery time is not allowed for these effects to diminish, or if the motions also involve awkward postures or forceful exertions, the risk of actual tissue damage and other musculoskeletal problems will probably increase. A task cycle time of less than 30 seconds has been considered repetitive."    (Continued via )    [Ergonomics Resources]

Ergonomic Paint Brush

Security Ergonomics

Ergonomics applied to the security industry ...

"Last week, IBM’s top security and privacy professionals attended an annual internal conference down in Austin, Texas. Over three days there were around 40 sessions divided in to two streams covering diverse topics ranging from detecting Web application vulnerabilities using static analysis, through to European national e-ID card scheme evaluations. As conferences go, it was pretty good, and I actually found it more interesting than some of the external/commercial conferences that I’ve attended recently.

Not only was I lucky enough to attend, but I also had a submission accepted – and spoke on the topic “how too good security can become no security”.

Now, I’m not going to cover the presentation here in any detail (I’ll aim to cover some of the threats in later blog entries); but while I was preparing the slides and doing some auxiliary research, two statements (let’s call them “perspectives”) came to dominate the topic.

1. An attacker doesn’t need to be smarter than the protection, just smarter than their victim.
2. “There is no patch for stupidity” is a copout.

The gel between these two statements is complexity.

The security industry tends to develop and implement new protection strategies in a very linear way (e.g. if the attacker beats two-factor authentication, introduce another element and make it three-factor authentication, etc.). In fact, one of the core mantra’s of security is “defense in depth” – i.e. keep on adding layers of protection to cover the full spectrum of threat. The net result of all this is that most defenses are complex – complex to manage and complex to use.

Therein lies the crux of the problem. The end consumer is overwhelmed with all the layers of security they have to pass through just to do something as simple as checking an online bank balance.

... What’s the response from some security professionals? “There’s no patch for stupidity” – i.e. the victim should be blamed because they couldn’t figure it all out and did something they shouldn’t have. Which, to my mind, is the ultimate copout - complexity is our failure, and the attackers gain.

Personally, I think it’s time we rethink many of the protection strategies the security industry adopts and deploys to protect Joe Average consumer.

Perhaps the industry needs to spend some time thinking about the ergonomics of consumer security before adding yet another defense-in-depth barrier?"    (Continued via Frequency X Blog)    [Ergonomics Resources]

On-Screen Keyboard simplifies input on mobile and kiosk PCs

New on-screen keyboard ...

"Comfort Software Group proudly announces the release of Comfort On-Screen Keyboard, a powerful on-screen keyboard application for a wide range of users. The software displays a unique virtual keyboard on the screen and enables you to use the mouse cursor or the touch screen to type text in any available language. The rich functionality and ergonomics of Comfort On-Screen Keyboard will be especially appreciated by the owners of ultra-mobile PCs (UMPCs), tablet PCs and e-kiosk creators, as it provides an easy way or facilitating user input and making it more efficient.

Comfort On-Screen Keyboard supports all the keys found on regular keyboards, but also possesses a number of distinct advantages. Support of mouse gestures simplifies the input of capital letters, spaces and enables you to delete the last character with a single stroke of the mouse cursor. The auto-repeat function repeats the input of a character when the key is pressed and held down. The virtual keyboard displays shortcuts and icons of popular application right on its keys, so you won't have any problems finding the right hotkey. This is more, when you switch to any language installed in the system, the keyboard will immediately display its characters on the keys, which provides you with a plethora of virtual keyboards to choose from. Flexibility and a multitude of customization options are some of the greatest advantages of Comfort On-Screen Keyboard - you can specify the position of keys on the keyboard and their number, keyboard dimensions, the interface color and even the
skin to be used. The software comes with a number of templates, so you can choose the one that best matches your mood, desktop background or device type.

The bottom line is simple - you are very unlikely to find a more functional, elegant and useful on-screen keyboard tool anywhere else. Get it, install it on your home PC, your UMPC, corporate tablet PC or even an e-kiosk, tailor it to you needs and enjoy fast and hassle-free multi-language input!"    (Continued via Comfort Software Group)    [Ergonomics Resources]

On-Screen Keyboard

Station Crew Back to Business as Usual

Space station ergonomics ...

"After space shuttle Endeavour undocked from the International Space Station Monday, ending the STS-123 crew’s 12-day stay at the orbital outpost, the Expedition 16 crew got back to business as usual.

Commander Peggy Whitson depressurized the station’s Pressurized Mating Adapter 2 to prevent condensation and pressure fluctuations, followed by a leak check an hour later. She also powered down the Robotics Workstation laptop.

Flight Engineer Yuri Malenchenko finished reconfiguring the Russian telephone/telegraph subsystem (STTS) to its post-undocking settings. The STTS enables telephone communications between different parts of the station.

The newest Expedition 16 crew member, Flight Engineer Garrett Reisman, set up the Elaboratore Immagini Televisive - Space 2 (ELITE-S2) payload. ELITE-S2 is an Italian experiment that records and analyzes the three-dimensional motion of astronauts. This study will help engineers apply ergonomics into future spacecraft designs and determine the effects of weightlessness on breathing mechanisms for long-duration missions.

After working on these and other jobs on undocking day, the crew had some off-duty time Tuesday and performed a number of tasks later in the day. Among other tasks, Whitson worked on an experiment that monitors sleep/wake patterns and light exposure, and Malenchenko did routine maintenance on the station’s Environment Control and Life Support System. All three crew members spent time exercising."    (Continued via The Space Fellowship)    [Ergonomics Resources]

International Space Station

Computer models ease Ford workers' tasks, raise quality

Designing ergonomics into the job ...

"On Tuesday, Ford showed off its secret virtual operations to the media in its manufacturing development center on Mercury Road in Dearborn.

The facilities help Ford re-create automotive factories, parts and cars that are lifelike -- with the exception of their bright candy colors -- so that virtual autoworkers can assemble them and pinpoint problems in the computer world, which is less expensive and faster than the real world.

Dan Hettel, chief engineer for vehicle operations at Ford, said the operations have taken on increasing importance as the automaker tries to get new cars and trucks to market faster and with better quality.

"There's just no time to do it any other way," he said. "We create a whole virtual factory where we build the vehicles."

The approach has reduced the amount of expensive and time-consuming work Ford has had to do with pre-production vehicles. Vehicles now reach that stage with fewer ergonomic and other problems, Hettel said.

This sophisticated computer-aided approach helped Ford improve its quality by 11% last year, while the industry improved just 2%, according to a 2007 study by Global Quality Research System. The study was commissioned by Ford.

Ford's virtual software, developed with the help of German supplier Siemens AG, also includes a digital human model, which is essentially a smart avatar that records critical facts for engineering the process required to build a car or truck. That includes facts such as the stress on joints to move a heavy part or how far an autoworker must reach to install a bolt or wire.

The data are then used to make the job simpler and less stressful on the body, said Allison Stephens, Ford's ergonomics technical specialist with vehicle operations manufacturing engineering.

"Our digital employees -- Jack and Jill -- are helping us predict the ergonomic effect of long-term repetitive motions," she said. "The impact on health and safety metrics, as well as on quality, has been tremendous."

The more difficult a job is to complete physically, she explained, the less likely it is to be completed properly. So Ford uses the data to make tasks easy enough to be done correctly during the time allotted.

The automaker also wants to ensure that jobs are easy to perform ergonomically to reduce injuries, which results in employee turnover. Tasks are also more likely to be completed correctly when there is more stability and less rotation of personnel, Hettel said."    (Continued via Detroit Free Press)    [Ergonomics Resources]

Assembly Line Ergonomics

Spring Is Springing, And That Means… Back Pain?

Tips for ergonomic gardening ...

"Gardening is a surprisingly common cause of back pain, and now that the sun is out, it's important to know how to work in your yard without hurting yourself.

Leigh Allen, physical therapist at San Francisco Sport and Spine Physical Therapy suggests the following tips for beautifying your garden without hurting your body.

Warm Up: You wouldn't play sports or work out without warming up, so it makes sense to warm up before doing something as physical as gardening. A quick walk and some gentle stretching can work wonders before hunkering down to the flower bed.

Change Position Frequently: Prolonged static positions can be damaging. When doing a lengthy task, change positions frequently. If you're working close to the ground, as in weeding, you can sit, kneel, half-kneel, and get on all fours. Vary your position to give your back a break.

Shift Tasks or Take Breaks: Rotate through your tasks so you're not doing any one thing for too long. Weed for 10 minutes then switch to raking, then to clipping, then back to weeding, etc. If you've only got one job to do, then just make sure you take a stretch break and/or change position every 10-15 minutes.

Use Good Body Mechanics: Always make sure to avoid bending in your back, especially when lifting. Keep your back straight, tighten your abdominal muscles, and bend at the hips and knees. Don't lift too much at once. Break large loads up into several smaller loads. Use a smaller spade when digging. And move your feet to avoid unnecessary twisting in your back.

Use Ergonomic Tools: Lighter-weight tools ease the load on your back, and tools that allow you to stand instead of bend over are back savers as well. A quick search can find websites that sell ergonomic gardening tools, like Gardeners.com.

"If you're worried about your mechanics or your back when getting back out into your garden," says Allen, "contact your physical therapist. They can review body mechanics with you and even teach you exercises specifically designed for you and the tasks you want to do."    (Continued via PRWeb)    [Ergonomics Resources]

Tips for Talking Safety to the CEO

Selling a safety program to management ...

"What do you do if your organization's CEO questions the return on investment of safety and health programs? How would you negotiate safety programs into your organization's long-term business plan?

These questions were asked of safety managers gathered at the American Society of Safety Engineer's conference, The Business of Safety: A Matter of Success held in Baltimore March 13 and 14. The overall theme of the conference explored ways to help safety professionals enhance communication with management and secure a seat at the financial and strategic planning table.

Following are several gems of insight from attendees and presenters at the conference to answer those two questions.

Be strategic-minded. Be strategic-minded and professional in all dealings with the organization's executives; they generally do not like emotional responses to their questions or inquiries, according to Michael Behm, PhD, CSP. Be prepared to present current costs and benefits with projections that show the outcome of a "keep everything as it is" scenario, and the costs/benefits of one or more alternative plans with projected outcomes. Include your recommendation and the justification (e.g., documentation, calculations, expert support) for your proposal.

Ask for help. Tap resources within your own organization for help preparing your proposals in the format and business language preferred by the executive team. If they prefer spreadsheets and charts for interpreting financial information, learn to use spreadsheets and charts to present proposals.

Be clear when discussing financial values and when discussing intangible values. Make it clear when you are discussing monetary or financial cost/benefits and when you are addressing non-financial or less tangible values like company reputation, employee morale, or ethical considerations."    (Continued via BLR)    [Ergonomics Resources]

Fine-Tuning Your Ergonomic Intervention

Intervention tips for ergonomics program ...

"Many computer and ergonomic websites now provide valuable information on guidelines for sitting and working posture. Many human resources personnel are being trained in ergonomic basics. However, there are times when everything at the workstation looks right but the worker continues to suffer from repetitive strain pain. Here are a few tips to fine-tune your ergonomic intervention.


1. Ergonomics is about the worker interacting in his work environment. During their ergonomic evaluations, employees often tell me that they showed up at work one day and had a new piece of ergonomic equipment sitting on their desk. No observation or training was offered. Equipment was purchased because the employer was told that this particular piece of equipment would stop injuries and save the company money. Although in some cases this approach may work, it can often backfire. Employees who are not trained, who do not have the opportunity to provide feedback and offer suggestions, and who are treated in a one-size fits all manner will often reject the equipment or receive equipment that they do not need. These make for expensive paperweights and do nothing to solve potential problems. Make time to get to know the employees, talk to them about what they feel the issues are, observe their working habits, and treat each one as an individual. Since they are the ones performing the job, they will have some valuable feedback to provide and will help guide your intervention.

2. Listen to the worker. Begin with the proper ergonomic set-up. However, ergonomic guidelines are just that – guidelines. What works for one person may not work for another. Keep an open mind and listen to what the employee is telling you. He or she knows what a certain set-up feels like while you can only observe.

3. Give ergonomic adjustments some time. Any piece of new equipment or new arrangement will take two to six weeks to adjust to properly. Productivity may temporarily decrease during this adjustment period. Don’t make alterations to a work station during a busy output time or the employee will become frustrated with the inability to perform at normal speed. As familiarity and comfort with the new set-up improves, productivity should reach prior levels. And as pain resolves, productivity will most likely increase. If after one to two weeks the employee reports an increase in pain, the new ergonomic changes may not be appropriate for that employee."    (Continued via Bella Online, Marji Hajic)    [Ergonomics Resources]

ANSI Board Rejects Bid to Block Construction Ergonomics Standard

Ergonomics bills constantly under pressure ...

"The American National Standards Institute Board of Standards Review today rejected an appeal seeking the withdrawal of the adoption of the ANSI/ASSE A10.40-2007 standard addressing musculoskeletal problems in construction, the American Society of Safety Engineers announced. ASSE is the standard's secretariat; the appeal was made by the Construction Industry Employer Coalition, a coalition of five trade associations.

ASSE said a hearing was held May 1, 2007, to hear the coalition's formal complaints. On May 25, 2007, the appeals panel found unanimously that the complaints had no merit and that ASSE had complied with ANSI due process requirements in developing the standard, according to ASSE, which said the standard was approved by ANSI’s Board of Standards review on July 23, 2007. The coalition then appealed. Now, A10.40 stands as an American National Standard.

"We are pleased with ANSI Board of Standards Review's decision to uphold the approval and publication of the A10.40 standard," said James D. Smith, CSP, ASSE's vice president, Council on Practices and Standards. "At ASSE, we are committed to the protection of people, property, and the environment, and this standard is an excellent step in protecting workers from injury and in helping to create safer and more healthy workplaces."

The standard includes elimination, substitution, engineering and administrative controls, training, use of PPE, assessment of individuals’ physical capabilities. It also contains a list of non-occupational risk factors associated with work-related MSDs, such as age, strength, and gender."    (Continued via Occupational Health & Safety)    [Ergonomics Resources]

The Ergonomic Effect

Examples of ergonoic benefits ...

"Still not convinced of the benefits of ergonomic programs among contact centers? Many studies over the years have demonstrated the positive effects of ergonomics. Some are highly documented. Some are anecdotal. Here’s a few to help you understand the significant impact a proactive approach to ergonomics can have on your organization.

• At one cable TV company, merely repositioning the keyboards and monitors resulted in a 10% increase in calls handled each day.

• A study at one insurance company showed that ergonomic furnishings costing the company approximately $500,000 contributed more than $620,000 in improved productivity.

• At a telephone company, the introduction of an ergonomic program cut agent turnover rates from 35% to just 2% per year.

• A major insurance carrier completed several “before-and-after” studies of upgrades from open, bullpen-furniture arrangements to enclosed cubicles, noting productivity increases ranging from 5% to 21%.

• Ninety percent of the 200 decision-makers responding to a survey said better office design can improve productivity. And 68% said they had increased productivity and decision making by placing group members together. (The survey was conducted by the American Society of Interior Designers.)

• A survey of one company’s employees conducted two months after they moved into a new building with an open office concept showed 60% believed that productivity had improved and 80% had a higher level of customer focus. One area of concern was the fact that only 40% of the employees felt the organization was effectively sharing its best practices across departments.

• Automation and agent performance - Another study looked at the impact that facilities have on worker effectiveness and job satisfaction in contact centers. The conclusions were drawn from a database of more than 1,500 respondents from a cross-section of 70 companies in seven major industry segments."    (Continued via Multichannel Merchant)    [Ergonomics Resources]

Texting-On-The-Go Said to Injure 6 Million British

Texting and walking at the same time ...

"Texting while walking down the street is a dangerous combination. According to this study carried out by the British directory service company 118118, last year more than one out of ten British people needed treatment for injuries including broken noses, cheekbones and even in one case a fractured skull, caused by walking into things while sending an sms message. The Daily Express calculated this means that 6 million Brittons got hurt last year. Although, admittedly, the research was based on a sample poll:

Research among 1,055 adults discovered that 63 per cent concentrate so hard when they are texting that they become “blind” to objects around them.

Makes you wonder about the sample doesn't it? How many people do you know who had to be treated in the hospital as a consequence of mobile phone use while walking? And considering that 'in response to the research' 118118 is now offering padding to lamp posts (see movie) and the amount of free media attention that is getting, we might want to reconsider the value of this study. Though I don't want to withhold this piece of advice from you:

Mobile phone users are now being advised to use template messages to speed up texting and look up every five seconds to avoid hazards."    (Continued via the product usability weblog)    [Ergonomics Resources]

5 Things: Preventing Carpal Tunnel Syndrome

Tips for preventing CTS ...

"Since many of us are working on a computer all day, we may be putting ourselves at risk for carpal tunnel syndrome (CTS). It happens when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. This nerve controls sensations to the palm side of your thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel is a narrow passageway of ligament and bones at the base of the hand, which houses the median nerve and tendons.

Some people are more prone to this because they have a smaller carpel tunnel. For this reason, women are three times more likely than men to develop CTS. It can also be caused by an injury, fluid retention during pregnancy, or repetitive motions like using a mouse or keyboard.

Here are some ways to prevent the pain and tingly sensations caused by CTS:

1. Check out the ergonomics of your desk setup. Adjust the height of your chair so that your forearms are level with your keyboard so you don't have to flex your wrists to type.
2. Using one of those pads that run along the length of your keyboard will prop up the heels of your palms, so that your forearms, wrists, and hands are in one straight line, which could prevent the nerve from getting squeezed. If your mousing hand bothers you, try one of those mouse pads that has extra cushioning you can rest your wrist on.

There are a few more suggestions, so read more

3. You may benefit from using one of those ergonomic keyboards so that your hands and wrists type in a more natural position.
4. If you're using a regular mouse and it bothers your wrist, pick up a vertical mouse so that your thumb is pointing straight up. It may feel more comfortable on your wrist.
5. Take breaks from mousing and typing. Shake out your wrists or do some wrist stretches."    (Continued via Fitness, Health & Well-Being)    [Ergonomics Resources]

Avoiding CTS

Employees sitting too long, stressing backs

Work habits influence ergonomic health ...

"Many of us are spending more time at the office, and injuring ourselves in the process.

One in ten Canadians reports a repetitive strain injury serious enough to limit normal daily activities.

Injuries are caused by typing, using a computer mouse, talking on the phone and staring at computer screens for hours on end.

In fact, sitting too long is the most common mistake employees are making, according to Diane Stinson, the owner of Healthworks, which specializes in ergonomics.

"People are working long hours, not taking breaks, skipping lunch and taking work home with them.

The longer you sit, the more stress you put on your body, so we suggest you don't sit for longer than 50 minutes," says Stinson.

She says get up, walk around the office, even try some simple stretches to reduce back strain and poor posture.

Stinson helps companies outfit employee work stations with the latest in ergonomic furniture.

When Calgary company Newalta recently moved into a new office building, it invested in desks that convert from sitting to standing with the press of a button.

It also purchased foot rests, ergonomically designed keyboards and mice and head sets, for employees who spend long hours on the phone.

Kelly Conrick, a Newalta employee, says people don't place enough importance on their posture, until it's too late.

"I could hardly move my neck! I could move one side, but not the other side. It not only affected me at work, but at home as well," says Conrick.

She's a lefty, but was trying to force herself to work at a right-handed work station.

Ergonomic assessments usually only take about 45 minutes to an hour, and can be particularly helpful for people who are overweight or with special medical concerns.

But Stinson believes all employees can improve their office space, and employers benefit as well."    (Continued via Canada.com)    [Ergonomics Resources]

Posture Talking On Phone

Use of medical devices by hospital staff under scanner

Medical device ergonomics under scrutiny ...

"The death of two newborns in incubators at hospitals in Delhi and Ahmedabad last week has raised questions over safety of patients seeking medication through various medical devices. Incidentally, the recent study of usability issues of medical devices in intensive care unit (ICU) in some hospitals in and around city has revealed serious deficiencies of life supporting devices and its usage.

“The issue of usability of medical equipment in hospitals across the country is very serious. The initial study has revealed that there is need to impart training of using medical devices to the assistive staff along with designing of devices,” said Ganesh Bhutkar, assistant professor at Vishwakarma Institute of Technology (VIT) who is pursuing PhD in medical usability.

... “The issues raised in the study are common, but might be prevalent in the small hospitals,” he said, adding, the hospitals need to insist on training of its staff by manufacturers of the medical devices. The misuse of the device can lead to fatality and it should be a must to improve the medical usability of devices, he said.

Bhutkar's research guide Katre said the usage of devices should take into account the local needs of the hospitals and its employees considering the proficiency of the assistive staff. "The instructions should be given on usage in local language and should include graphical symbol for easy understanding."

The study and observations show major scope for enhancing the medical devices from usability perspective. Considering the life criticality and the impact of design on users like ICU patients, sisters and physicians, the proposed enhancements must be accorded highest priority, Bhutkar concludes.

His findings of survey have been published in Journal of HCI Vistas and will soon feature in the journal, Ergonomics Australia. The research paper “Ergonomic Issues of Computer Based Products Used in Intensive Care Unit” was also presented at the Conference on Humanizing Work and Work Environment (HWWE) 2007 in Bhopal."    (Continued via Expressindia.com)    [Ergonomics Resources]

Businesses should do more to avoid repetitive strain injuries...

Reaching out to avoid RSI ...

"RSI Action is a UK charity working to facilitate the prevention of RSI (Repetitive Strain Injuries) conditions and for the relief of sickness, hardship and distress amongst those suffering with RSI.

The RSI Action annual conference was held in London on 1st March 2008. It opened with some stark statistics: in the UK 30.7 million days are lost to illness every year and of those 3.5 million are categorised as upper limb disorders. RSI and upper limb disorders are different terms that cover roughly the same set of symptoms. People can and do argue about the differences but however we cut the statistics we can say that about 10% of sick days are connected to RSI. If businesses could reduce that number then would reap a considerable financial benefit from:

* The increased number of productive days. Besides the actual days of sick we should add many days before and after the sickness when the employee is less than fully productive.
* The reduced management time involved in coping with the effects, direct and indirect, of the absences.
* The extra cost of health care provision.
* The cost of successful damages claims by employees.
* The cost of legal proceeding relating to all claims for damages.

BP and GlaxoSmithKline presented on how they are dealing with RSI. In both cases they have set up projects to increase the awareness of their employees and management of the potential problems and the generally simple actions that can be taken to reduce the risk."    (Continued via IT Analysis)    [Ergonomics Resources]

ANSI Board Rejects Bid to Block Construction Ergonomics Standard

Preventing the blocking of ergonomic rules ...

"The American National Standards Institute Board of Standards Review today rejected an appeal seeking the withdrawal of the adoption of the ANSI/ASSE A10.40-2007 standard addressing musculoskeletal problems in construction, the American Society of Safety Engineers announced. ASSE is the standard's secretariat; the appeal was made by the Construction Industry Employer Coalition, a coalition of five trade associations.

ASSE said a hearing was held May 1, 2007, to hear the coalition's formal complaints. On May 25, 2007, the appeals panel found unanimously that the complaints had no merit and that ASSE had complied with ANSI due process requirements in developing the standard, according to ASSE, which said the standard was approved by ANSI’s Board of Standards review on July 23, 2007. The coalition then appealed. Now, A10.40 stands as an American National Standard.

"We are pleased with ANSI Board of Standards Review's decision to uphold the approval and publication of the A10.40 standard," said James D. Smith, CSP, ASSE's vice president, Council on Practices and Standards. "At ASSE, we are committed to the protection of people, property, and the environment, and this standard is an excellent step in protecting workers from injury and in helping to create safer and more healthy workplaces."    (Continued via Occupational Health & Safety)    [Ergonomics Resources]

Americans Not So Sleep Deprived, Says University of Maryland

Not sleep deprived? ...

"Contrary to conventional wisdom, Americans average as much sleep as they did 40 years ago, and possibly more, according analysis by University of Maryland sociologists.

The researchers report that adult sleep averages have increased about three hours per week over the last decade, up from 56 to 59 hours. They based their analysis on data from time diaries collected jointly by the U.S. Bureau of Labor Statistics and U.S. Census Bureau. Respondents aged 18 to 64 were asked to report all their activities the previous day in chronological order.

The Maryland study, Not So Deprived: Sleep in America, 1965-2005, identifies long working hours as the main "thief" of sleep, though most Americans still manage to average at least the "proverbial" eight hours of rest each night.

"Many Americans work too much, but most don't seem to be cutting corners on their sleep to do so," said University of Maryland sociologist John P. Robinson, lead author of the study. "Lots of people may feel like they're on a 24/7 treadmill. But the picture of the typical American as sleep-starved is not consistent with what they report in their time diaries."

Even so, the study found that working hours remain the prime predictor of sleep averages. Age and gender differences disappear when working hours are taken into account. Heavy work schedules, for example a second job, can reduce sleep averages by up to 10 hours per week."    (Continued via Occupational Health & Safety)    [Ergonomics Resources]

Can You Hear Me Now? The Impacts of Hearing Loss

Reducing noise related injuries ...

"Though it's one of the most common workplace injuries, noise-induced hearing loss also is one of the most overlooked. Employees and employers who don't pay attention to the importance of hearing protection potentially could lose much more than just their hearing.

As a hearing conservationist, National Hearing Conservation Association (NHCA) President Theresa Schulz has heard more than her share of heartbreaking stories from workers suffering from hearing loss. But nothing prepared her for the compelling story she heard during a presentation at an annual NHCA conference almost a decade ago.

The presenter was a former construction worker in his mid-forties who had significant hearing loss. He started working in construction in his teens, often using jackhammers without wearing hearing protection. He explained during the presentation that a few years ago his sister, with whom he had a strained relationship, was diagnosed with terminal breast cancer.

As she was dying in the hospital, the two tried to mend the rifts in their relationship. She tried to tell him something, but because she was surrounded by the buzzing sounds of medical equipment, he wasn’t able to hear what she was trying to say.

According to Schulz, the presenter told the audience that not hearing her last words haunts him. “When people tell me you just hear what you want to hear, it makes me angry, because I never wanted to hear anything more than that in my whole life,” Schulz recalls him saying.

Examples like this point to how devastating hearing loss can be for a worker, not just because it impacts his or her actual ability to hear, but also because it can affect personal and emotional well-being.

While noise exposure is a pervasive problem in the workplace – it is estimated that the number of workers who suffer from noise-induced hearing loss is in the tens of millions – it is entirely preventable.

Twenty years ago, OSHA implemented detailed noise exposure regulations (29 CFR 1919.95) and since then, many employers and safety professionals diligently have monitored noise levels at work sites, posted warning signs, purchased earplugs and routinely testing employees’ hearing. Yet noise-induced hearing loss continues to occur at an alarming rate."    (Continued via Occupational Hazards)    [Ergonomics Resources]

Equipois Introduces the Revolutionary zeroG(TM) Arm Technology to Combat Injury and Inefficiency in the Workplace

Creating zero gravity ...

"Equipois Inc. announced the launch of its zeroG(TM) line of products, which renders tools, parts, and even the human arm effectively weightless while allowing unmatched freedom of motion. The company introduced the product line at the keynote luncheon of the Applied Ergonomics Conference and Expo today in Orlando, Florida.

Designed by legendary inventor Garrett Brown, the zeroG(TM) technology utilizes a patented spring, cam and gimbal-based architecture to "float" objects as if they weigh virtually nothing while allowing them to be maneuvered almost effortlessly, with full range of motion and functionality. By significantly reducing the exertion required to operate tools and move materials, the zeroG(TM) technology reduces workplace injuries, a massive problem estimated to cost U.S. businesses more than $200 billion a year. It can also enhance productivity by increasing the speed and accuracy of industrial tasks.

Eric Golden, Equipois's founder and CEO, said: "With gravity effectively neutralized, workers can perform at a new level - they can accomplish more in a shorter time and with greater precision, all without suffering debilitating and costly injuries that businesses have until now been forced to accept as inevitable. In short, the zeroG(TM) technology allows workers to use their skill and judgment without using up their bodies...with significant savings to employees, employers, and customers."

Equipois's first offering, available for delivery starting in April of 2008, will be the zeroG4, which holds tools and parts weighing up to 36 pounds. Equipois tested and refined this technology in pilot projects with world leading companies in aerospace, heavy machinery, marine manufacturing, and other industries.

United States Ergonomics, an independent firm of Certified Professional Ergonomists, conferred the zeroG with its highest "Ergonomic Certification" after putting test subjects through a range of exercises. "We are extremely impressed with this product's capabilities and performance," said Kevin Costello, President of United States Ergonomics. "Our tests revealed that the zeroG produces dramatic reductions in user muscle effort and fatigue potential. The zeroG will allow employees to work longer with less effort." Costello also noted that test subjects uniformly found the zeroG extremely easy to learn and use and offered high praise for its performance, even when maneuvering weights up to 24 pounds throughout their full range of motion."    (Continued via centredaily.com)    [Ergonomics Resources]

zeroG

The Evoluent Vertical Mouse - A Product Review

A review of the vertical mouse ...

"In 1994, the Evoluent VerticalMouse was patented. Its unique design places the forearm in a neutral, hand-shake position rather than in a palm-down position. This relieves pressure on muscles and compression on nerves in the forearm that may become tight and pinched during long hours of positioning with the forearm in the palm-down pose. In spite of an enthusiastic response from trade show attendees, the larger mouse production companies did not share his vision and it took Jack Lo, the designer, over 8 years to move through the stages of product research, design and development before the release of the first Evoluent VerticalMouse in 2002. Since that time, the Evoluent Vertical Mouse has undergone 2 additional revisions with the goal of helping more people “cure and prevent mouse injuries”.

Design

The Evoluent VerticalMouse is about the same height and width of a standard mouse. In fact, it looks very much like a mouse that has been positioned on its side. The most obvious difference from a standard mouse is in the height and button placement. The buttons are placed on the outside edge of the mouse with an indentation for the thumb on the inside edge. This mouse contains five buttons - three standard-sized buttons along the outside edge, a scroll wheel along the outside edge between the top and middle button, and a long, thin oval-shaped button in the thumb indentation along the inside edge. The top button performs the traditional left mouse click functions. The middle button performs the traditional right mouse click functions. The scroll wheel performs the traditional scroll functions. The remaining bottom button and thumb indentation button are for programmable functions. In fact, all five buttons are programmable with 59 different functions available through free shareware. Links are available through customer support on the Evoluent website. The buttons are easy to activate with a light force but are firm enough to prevent accidental mouse clicks.

Who Will Benefit From Using the Evoluent VerticalMouse?

* The neutral forearm positioning is comfortable and recommended for anyone with forearm or wrist pain and swelling.
* This mouse is also recommended for those with a tendency to activate the mouse by swiveling through the wrist rather than keeping the wrist neutral.


Pros

* Very comfortable to hold and to manipulate. Button activation is smooth. The scroll wheel in the latest version (the VerticalMouse 3) has been redesigned with detents (clicks) to provide improved feedback. The Vertical Mouse 2 offers a smooth rolling scroll wheel. The VerticalMouse 3 offers a small lip on the bottom edge to prevent the small finger from rubbing against the desk surface.
* Button activation and use is similar to standard mice so that adjustment time is short.
* Elegant appearance in a professional black matte with a soft-touch coating and choice of glossy black or silver buttons in a calming wave-like design."    (Continued via Marji Hajic, Bella Online)
[Ergonomics Resources]   [Visit Ergonomics Store for Vertical Mouse]

Driving study deals blow to hands-free phones

Brain not prepared for cell phone and driving ...

"Simply listening to a cellphone distracts drivers, a study concludes. The finding raises questions about the effectiveness of laws that ban only the use of handheld devices while driving.

California, Connecticut, New Jersey, New York, Washington, the District of Columbia and the Virgin Islands prohibit drivers from using handheld cellphones, but no jurisdiction bans hands-free phones, says Jonathan Adkins, spokesman for the Governors Highway Safety Association, which represents state and territorial highway safety offices.

Allowing hands-free phones "really gives drivers a false sense of safety," Adkins says. He adds that he has seen no evidence that bans on handheld phones have prevented accidents.

Neuroscientist Marcel Just, director of the Center for Cognitive Brain Imaging at Carnegie Mellon University in Pittsburgh, agrees. Just studied 29 volunteers who used a driving simulator while inside an MRI brain scanner. The volunteers steered a car along a virtual winding road undisturbed or while deciding whether a sentence they heard was true or false.

Listening while driving led to a "significant deterioration in driving accuracy," Just and his co-authors write in the latest issue of the journal Brain Research. The drivers hit the guardrail and veered out of the center of the lane more often while listening."    (Continued via texturaly.org, USA Today)    [Ergonomics Resources]

Brain

Preventing iPod, PDA & SmartPhone Hand Pain

Guidelines for use of handheld devices ...

"According to The American Society of Hand Therapists (ASHT), heavy use of handheld electronic devices can lead to hand ailments. In this national consumer education alert - initially issued in January of 2005 and recently reissued - professional hand therapists offer tips for preventing injuries caused by the extreme use of small personal music devices, smart phones and PDAs.

The excessive use of scroll wheels and frequent text-messaging associated with portable electronic devices are causing thumb, finger and wrist pain. “We are giving our thumbs, wrists, and elbows a real workout with heavy use of handheld electronics like blackberries and iPods,” said former ASHT president Donna Breger Stanton. Injuries such as carpal tunnel syndrome, “BlackBerry Thumb” and tendinitis are being seen with increasing frequency as the use of these popular devices is increasing.

ASHT GUIDELINES FOR HEALTHIER USE OF HANDHELD ELECTRONIC DEVICES – A SUMMARY

Respect Pain. If you have pain while using a hand held device, stop and take a break. Pain is the body’s warning sign that something is wrong. Pain may be indicating that you are straining muscle groups.

Be aware of wrist positioning. Hold the device with the wrist in a neutral position (not bent forward or back or angled to either side). Even a small amount of wrist angulation can increase tension on the tendons and nerves.

Take a break. Every 20 minutes or so, take a micro-break (stop the activity for one or two minutes, stretch, or switch to another activity). Repetitive motions such as pressing small device buttons can cause inflammation of the tendons or cause nerve irritation.

Relax your arms. If possible, place pillows in your lap and rest your arms on the pillows. Or use the device with the forearms supported on a desk or tabletop (however, do not lean the elbows onto a hard surface or press the elbow or forearms onto the sharp edge of the desk). This will allow you to keep your head in a more upright position than if the device is held in your lap and therefore decrease neck strain. The pillows or desk will help support the arms so they do not have to be held up in the air.

Sit in an appropriate chair. This is a chair that allows you to put your feet comfortably on the floor and also provides good back support."    (Continued via Bella Online, Marji Hajic)    [Ergonomics Resources]

APHA Check Emergency Kits When Turning Clocks Ahead

Turn clocks forward this evening ...

"The American Public Health Association (APHA) launched a new campaign to encourage Americans to check their emergency preparedness kits when they change their clocks for daylight saving time on March 9.

"Since we already use daylight saving as an opportunity to ensure that our families are prepared for an emergency, it's a great time for us also to make sure that we have a fully stocked emergency kit and that none of the perishable items have expired," said Georges C. Benjamin, APHA’s executive director. "When we spring forward this year, we want every American to make sure their family has a preparedness
kit to fall back on in the event of an emergency."

The "Get Ready: Set Your Clocks, Check Your Stocks" campaign urges people to gather or refresh their emergency supplies before a disaster or disease outbreak occurs. APHA recommends that emergency kits include at least a 3-day supply of non-perishable food and bottled water for each person, as well as any essential medication.

APHA points out that this also is an ideal time for people to re-familiarize themselves with their community’s emergency preparedness plan, including evacuation routes, emergency shelters and food bank locations. Citizens also should check their smoke detector batteries."    (Continued via Occupational Hazards)    [Ergonomics Resources]

Research Suggests Mid-Level Computer Screen Displays Can Minimize Musculoskeletal Strain in Schoolchildren

Display height affects posture ...

"A new study by human factors researchers in Australia suggests that students’ posture is affected by the height at which they view classroom learning materials. The researchers cited computer screen displays positioned at mid-level as causing less musculoskeletal strain than high- and book-level displays. Their findings were published in the February 2008 issue of Human Factors: The Journal of the Human Factors and Ergonomics Society.

The rapid increase in computer use by children over the past few years, say the authors, "has outpaced the development of knowledge about the ramifications for the health of children." For example, data from the Australian Bureau of Statistics indicate that in 2006, 80% of children aged 5 to 14 years used a computer at home.

Children are physically and behaviorally different from adults; for example, children’s heads are proportionately larger than those of adults. This makes research conducted on adults inadequate to address computer-related discomfort in children.

Because research on what constitutes the optimal display height for children is limited, Leon Straker and colleagues conducted a study in which they presented an interactive task to 24 children of normal height age 10–12. The children's movements were recorded with an optical capture system while they read from a book and wrote on paper or read from a computer display and used a mouse and keyboard to enter data. The researchers measured 3-D posture and muscle activity in the neck and upper limb for the high-, mid-, and book-level displays. The authors state that the study is unique in that it captures 3-D posture and muscle activity under conditions that are commonly observed in schools.

The high display resulted in mainly upward bending of the upper neck. As the visual target was lowered, head and neck downward bending increased. The mid-level display was found to promote a more upright and symmetrical posture and lower average muscle activity than either the high- or the book-level position. Of the three positions, the low (book-level) display was found to cause the most strain on muscles and joints."    (Continued via PhysOrg)    [Ergonomics Resources]

Simple Solutions for Office Hazards

Eliminating office hazards ...

"Office work spaces often have overlooked hazards that threaten the physical well-being of all who enter. Company co-workers or, if work is done from a home office, family members and pets, unknowingly can be in harm’s way. While some threats are fairly obvious, others can lurk in the most unexpected places.

In the office, equipment cables and wires can become a trip-and-fall hazard – and an expensive workers’ compensation case. Poised and ready to trip all who pass, office cables and wires are far more than an unsightly nuisance. Slips, trips and falls constitute the majority of general industry accidents. In the United States, they cause 15 percent of all work-related deaths and are second only to motor vehicles as a cause of fatalities, according OSHA.

In a home office environment, small children and common household animals like cats, dogs, rabbits and ferrets often see equipment wires as play things – all too often as chew toys. Clearly such a circumstance puts the child or pet at great risk, with electric shock and strangulation at the top of the list.

The experts at http://CableOrganizer.com offer these simple office safety solutions:

Cable Control on the Cheap:
For just a few dollars, computer cables can be easily shielded with a split wire loom, a flexible and durable polyethylene corrugated tube with a split down the side where you enter your multi-cable bundle. If you have to add another wire later on, you can easily slip it into the split wire loom along with the others without removing the entire bundle.

Achieve Lift-Off: Cables, power adapters, power strips, hubs, modems and other small devices can be readily lifted off the floor and put safely out of harm's way with cable management products that loop, tie and hang “cable clutter” off the floor to reduce work space risks including snags, trips and liquid spills.

Wire Fire Can Be Dire: With a glut of equipment, wiring and electrical outlets conducting heat, often over long periods of time and in compact spaces, fire safety is an important workspace consideration. In addition to the standard fire extinguisher, other fire safety measures also should be employed. Flame spread is one vital safety consideration that easily can be addressed. Flame-retardant wire sleeving that does not support combustion can significantly reduce office fire hazards. You also can establish an effective insulating barrier to prevent the spread of fire and smoke through structural gaps and voids with fire-rated expanding polyurethane foams – a cost-effective way to establish an insulating seal on concrete, brick, wood, metal, aluminum and steel."    (Continued via Occupational Hazards)    [Ergonomics Resources]

Keep Typing: Wrist Injuries Are Falling

Why RSI has declined ...

"Can a workplace epidemic be cured?

With the personal computing boom of the 1990s came thousands of "repetitive stress injuries" or "repetitive strain injuries." RSI became the hip medical acronym of the keyboard era, with subset carpal tunnel syndrome the diagnosis of the day.

"At its height of diagnosis, anybody showing up at a doctor's office with wrist pain or hand pain was being diagnosed with carpal tunnel," said Carol Harnett, vice president of insurer Hartford Financial Services Group Inc.'s group benefits division.

Since then, carpal tunnel cases have plummeted, declining 21 percent in 2006 alone, according to the Bureau of Labor Statistics. Among workers in professional and business services, the number of carpal tunnel syndrome cases fell by half between 2005 and 2006.

What changed?

First, it may not have been the white-collar epidemic it appeared to be.

A 2001 study by the Mayo Clinic found heavy computer users (up to seven hours a day) had the same rate of carpal tunnel as the general population. Harvard University headlined a 2005 press release "Computer use deleted as carpal tunnel syndrome cause."

"Clearly, if keyboarding activities were a significant risk for carpal tunnel, we should have seen, over the last ten to 15 years, an explosion of cases," said Dr. Kurt Hegmann, director, the Rocky Mountain Center for Occ